Individual
DANIEL R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1041 BRIGHTON AVE, PORTLAND, ME 04102-1042
(207) 699-4111
(207) 773-8814
Mailing address
1041 BRIGHTON AVE, PORTLAND, ME 04102-1042
(207) 699-4111
(207) 773-8814
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4699
ME
Other
Enumeration date
05/11/2016
Last updated
03/17/2018
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